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Another strategy to overcome the hypoxic TME relies on converting the high levels of HO in the TME into O by delivering natural enzymes such as catalase or using nanomaterials with high catalase-like catalytic activity [241]

The first large, controlled trial included 251 patients with an EDSS score between 0 and 5.5 and at least two relapses in the preceding 2 years, randomized to receive either placebo or 20 mg glatiramer acetate subcutaneous daily for up to 3 years (53)

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